ADMINISTRATIVE SUPPLEMENT FOR NOT-ES-20-012 to parent R21 (R21ES029616): ENVIRONMENTAL HEALTH OUTCOMES RESEARCH AMONG HURRICANE HARVEY SURVIVORS Abstract of the Parent Grant Flood waters from Hurricane Harvey (HH) damaged or destroyed more than 100,000 homes in the Houston area when over 50 inches of rain and flooding occurred. A dozen Superfund sites and several chemical/petroleum facilities were also involved in uncontrolled releases into the environment. Individuals and communities expressed environmental health concerns and reached out to us for assistance. In response, we formed a multi-institutional team with expertise relevant to NIEHS disaster research response (DR2) goals. With some institutional support we mobilized our team and developed study protocols, obtained IRB approvals with bi-lingual consents, and moved into the field within the 30-day window. We administered more than 150 health surveys, deployed equal number of wristbands, and collected more than 450 oral, nasal, and fecal biosamples, from individuals in 3 flooded communities. Based on our experience, we are confident that we can increase enrollment to 300 individuals complete with 6- and 12-month post-Harvey data. We hypothesize that individual- and neighborhood-level factors such as social support, access to resources, socioeconomic position (SEP), and proximity to point sources of contamination will affect health impact. We also hypothesize that personal environmental exposures to mold and chemicals will increase the health risks impacted by HH. We propose the following aims: Aim 1: To develop efficient methods for disaster epidemiology actions. We will conduct health assessments to identify the environmental health impact from HH at the individual and community level. Our overall goal is to develop and administer health risk assessments and exposure to flood waters in order to improve disaster research response (DR2) tools. These tools will be critical to optimize response rates, exposure measurements, and health assessments at 6 &12 months post-HH. Aim 2: To apply community-engaged research approaches to synthesize and disseminate findings and obtain resident feedback at 3 time points to inform study changes and provide the framework for the environmental health action plans for each neighborhood. These include recommendations for resource reallocation and tailored outreach programs to mitigate Harvey-related consequences. Aim 3: Evaluate the impact of Harvey-related exposures on short- and long-term health outcomes. Impact: Overall goal is to minimize the adverse environmental health effects of HH survivors and develop DR2 tools for improving rapid responses to other natural disasters in large urban centers.